Pipe dream: Drug store cigarette sale bans will make smokers quit

By Rob Eder

Just in time for the city of Boston’s proposed ban on the sale of cigarettes in drug stores, this letter landed on my desk from a Pennsylvania pharmacist (see below), who took exception to the column I wrote for the Aug. 18 issue of Drug Store News, titled “New SF law makes you wonder what mayor is smoking,” attacking the mayor of San Francisco and city council members there for passing a similarly misguided law that singles out stand-alone drug stores at the exclusion of every other retail outlet that currently sells cigarettes in the Bay Area. This summer, San Francisco voted to pass the law, which is set to take effect Oct. 1, unless Walgreens somehow proves successful in its bid for a court-ordered injunction to block the ban.

Actually, “misguided,” wasn’t exactly the word I chose to describe San Francisco’s new law. I said it was a stupid idea. I only said that because Lebhar Friedman, which publishes Drug Store News, is a family company. Otherwise, I can assure you, I would have chosen other—perhaps more colorful and certainly much saltier—words to describe the situation.

At least one reader, who agreed to allow Drug Store News to publish his letter, thought I had it wrong—

Editor, Drug Store News:

As a community pharmacist and healthcare professional, I was excited to see the outer [cover] of the latest issue (Vol. 30, No. 9), showing Miss America promoting smoking cessation. The inner [cover] showed an advertisement for the product, “Zerosmoke,” which was equally pleasing to see. Page 3 continued the campaign with the article about San Francisco’s ban on retail sales of tobacco products in pharmacies.

I was excited to see that “retail pharmacy” was in the early stages of banning the sale of cigarettes in pharmacies. My excitement turned to disappointment when I read the editorial written by the editor-in-chief, no less, saying in so many words that he disagreed with the ban, calling the idea “stupid.”

Now this ban comes from a city whose mayor and city council agree that a ban on the sale of tobacco will eventually lead to a decrease in tobacco usage. Whether or not it does is not the issue here. The sale of tobacco products, including cigarettes, cigars, pipe tobacco and chewing tobacco, is a contradiction of what pharmacists in the healthcare profession preach and teach to the patient/customer. I am sick and tired of filling prescriptions for metered dose inhalers for patients with COPD, asthma, bronchitis and emphysema only to see them continue to purchase and use tobacco products. I have actually heard a patient/customer say to me, “I am not picking up my prescription today, because I only have enough money to buy my cigarettes.” I recall a patient/customer pulling up to the drive-through window to pick up his Combivent inhaler with a lit cigarette in his mouth.

You say that it is unfair to drug stores to ban cigarette sales? Target, Wal-Mart, Costco, Giant, SuperFresh and other grocery [sic] chains may have pharmacies, but they are kept in a separate area in those stores away from the tobacco sales. Drug store chains like CVS, Walgreens and Rite Aid have tobacco sales just a few feet away from the prescription area. Also, CVS, Walgreens and Rite Aid are advertised as drug stores and pharmacies. ACME, SuperFresh, Giant, et. al., are advertised as food stores.

Now we do not see tobacco sales in furniture stores, apparel stores or hardware stores, so why the fuss about removing cigarettes from drug stores?

First a city bans the sale. Now it is up to the major drug chains themselves to further this cause. It is time for CVS, Walgreens and Rite Aid to take a stand and announce that they will stop the sale of tobacco products. The editor wonders what can we put in the “vacant real estate.” I am sure that the front-end manager will have no problem with this. How about a full line of smoking-cessation products and other products to benefit health?

Let’s make health care our number one focus by concentrating on the sale of products that improve overall health. The ban on smoking in public in some areas has already put a crimp in the smoker’s life. Now they have to go outside the building in the cold or the heat to smoke. Making it inconvenient to purchase tobacco products should be the next step. As an ex-smoker who sees the benefits of quitting, I feel strongly in offering Drug Store News my opposing opinion.

Respectfully,Bob Spera, RPh,Media, Pa.

With all due respect, to any of our readers that might disagree—in fairness, none of them, after all, wrote the law—I still think it is a really stupid idea.

Retail pharmacy is retail pharmacy—wherever it operates. Drug chains, supermarket pharmacies, mass merchandisers with pharmacies like Wal-Mart, Kmart and Target, club stores like Costco that operate pharmacies, and independents, both big and small, all are in the healthcare business. In fact, the top 10 pharmacy operators in America include three traditional drug chains (CVS, Walgreens and Rite Aid, Nos. 1, 2 and 3, respectively), two discounters (No. 4 Wal-Mart and No. 10 Sears/Kmart), three supermarkets (No. 6 Kroger, No 8 Safeway and No. 9 Supervalu), and two huge independent co-ops (Leader, No. 5 and Good Neighbor No. 7) operated by major wholesalers. (For a complete list see, Drug Store News POWER50, which ranks the top 50 pharmacy operators in America, April 21, 2008, page 108.)

None of those companies operate pharmacy as a separate division—pharmacy is as much a part of their stores as produce or baked goods. By that measure, the law is unfair to pure play drug stores for NOT selling furniture or hardware, or apparel, or any of the other merchandise that big-box pharmacies, sell along with prescription drugs, OTC medicines and cigarettes, too. The law also does nothing to prevent furniture stores, or any other type of retailer the reader mentioned, from selling tobacco products. It just singles out drug stores.

And that is why the new law is unfair.

Here are the reasons I think it’ stupid.

I am an ex-smoker, too. And all of the inconvenience in the world wasn’t enough to get me to quit; the price of cigarettes did it. The city of New York raised the tax on cigarettes, which it has done again since I quit four years ago. It now costs about $10 a pack—almost double what I paid when I quit. Here’s the catch: that tax is applied uniformly wherever cigarettes are sold in the city. New York City drug stores don’t collect more tax on cigarette sales than, say, the corner bodega.

So, if smokers are still willing to brave searing heat, freezing cold, and any and all of the elements, just to have a few puffs, what makes anyone think that making them cross the street or drive an extra block to buy a pack of cigarettes is going to stop them? You better believe the guy who is flipping a coin between buying the inhaler he needs to breathe and the cigarettes that are killing him, isn’t suddenly going to say, “aw, shucks—I guess I’ll just get this nicotine gum since the drug store stopped carrying my Pall Malls!” He is just going to go somewhere else and buy a pack of smokes.

Maybe he will even land in another retail pharmacy to buy his cigarettes, where some other pharmacist will have the chance to make a difference in his life. Maybe he will even choose to move his prescription business to that other pharmacy, too, where maybe he’ll be compliant with his meds, and maybe he won’t; maybe that pharmacist will try to get him to quit smoking, or maybe he won’t.

Maybe the pharmacist at the supermarket or the discount store won’t even know that patient is even in the store at all, since, after all, there is so much distance separating the pharmacy counter and the register where the cigarettes are sold. If anything, drug stores would have an even better chance of getting smokers to quit if customers actually had to go to the pharmacy counter to buy a pack, and catch an earful from the pharmacist first. Either way, those customers won’t be your problem any more.

To be fair—and not that it’s anything to brag about, to be sure—cigarettes and tobacco products historically have been one of the top-selling products at the front-end of the drug store, far outselling many traditional drug store categories, including OTC pain relief. Cigarettes are responsible for generating an awful lot of traffic into the drug store. To think for one second that drug stores will not lose a percentage of those customers—and likely a share of their pharmacy business, too—is just wishful thinking. Believing that a law like the one passed by the city of San Francisco and currently being considered in Boston might actually get people to quit smoking is just a “pipe dream.”